Fathers' Involvement in Child Health Care: Associations with Prenatal Involvement,Parents' Beliefs,and Maternal Gatekeeping

Using data from 182 dual‐earner couples experiencing the transition to parenthood, this study examined associations between prenatal involvement, gender‐role beliefs, and maternal gatekeeping and new fathers' involvement in child health care. Results indicated that prenatal father involvement was associated with fathers' direct engagement in child health care and perceived influence in child health‐related decision making. Fathers also demonstrated greater direct engagement in child health care when mothers held more nontraditional beliefs about gender roles. Moreover, when mothers were more encouraging of fathers' involvement in childrearing, fathers felt more influential in child health‐related decision making, whereas when mothers engaged in greater gate‐closing behavior, fathers with more traditional gender‐role beliefs felt less influential in child health‐related decision making. This study suggests that fathers' prenatal involvement, mothers' beliefs, and maternal gatekeeping may play a role in the development of new fathers' involvement in child health care at the transition to parenthood.     

Neighborhood Disorder and Paternal Involvement of Nonresident and Resident Fathers

Using data of 775 nonresident father families and 1,407 resident father families from the Fragile Families and Child Wellbeing Study, this study examined whether neighborhood disorder was associated with fathers' supportive involvement in child care. Bivariate analysis indicated that mothers and children of nonresident father families were more likely to live in disordered neighborhoods than those of resident father families. Multivariate analysis indicated that neighborhood disorder was negatively associated with nonresident fathers' involvement in child care, but not with that of resident fathers. In addition, relationship quality between the father and mother, father or mother married to or cohabiting with another person, fathers' income and alcohol dependence, and child health status were associated with nonresident or resident fathers' involvement. Policy and practice implications of the findings are discussed.     

Factors related to depression among higher income mothers with young children in day care centers

This study examined the association between maternal depression, maternal separation anxiety, social support, and maternal involvement in the day care center. A factor analysis identified a cluster of maternal involvement variables, including the amount of time spent in the center, frequency of communication with caregivers, maternal participation in caregiving, and mid-day visits to the center. The sample consisted of 54 mothers with infants in on-site, near-site, and off-site centers. Mothers who were more involved in the center reported less depression.     

The Effects of Father Involvement during Pregnancy on Receipt of Prenatal Care and Maternal Smoking

Objectives To examine whether women whose partners are involved in their pregnancy are more likely to receive early prenatal care and reduce cigarette consumption over the course of the pregnancy. This study also examines sociodemographic predictors of father involvement during pregnancy. Methods Data on 5,404 women and their partners from the first wave of the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) were used to examine the association between father involvement during pregnancy and maternal behaviors during pregnancy. Multivariate linear and logistic regression analyses were used and data were weighted to account for the complex survey design of the ECLS-B. Results Women whose partners were involved in their pregnancy were 1.5 times more likely to receive prenatal care in the first trimester and, among those who smoked at conception, to reduce their cigarette consumption 36% more than women whose partners were not involved in the pregnancy (p = .09). Fathers with less than a high school education were significantly less likely to be involved in their partner’s pregnancy, while first-time fathers and fathers who reported wanting the pregnancy were significantly more likely to be involved. Conclusions The positive benefits of father involvement often reported in the literature on child health and development can be extended into the prenatal period. Father involvement is an important, but understudied, predictor of maternal behaviors during the prenatal period, and improving father involvement may have important consequences for the health of his partner, her pregnancy, and their child.     

Maternal Perspectives on Deployment and Child–Mother Relationships in Military Families

Using survey data from 292 mothers married to members of the U.S. military, the authors examined relations among military deployment factors, quality of maternal care, and child attachment behavior with the mother. The results revealed that maternal perceptions of quality of care, mothers' depressive symptoms, and fathers' involvement when not deployed were significantly associated with children's attachment behavior. In addition, fathers' combat exposure was negatively associated with children's attachment behavior. Mothers' quality of care partially mediated the association between fathers' involvement and children's attachment behavior as well as the association between mothers' depressive symptoms and children's attachment behavior. A notable finding of this study was that deployment‐related factors were both directly and indirectly related to children's attachment.     

Patterns of mother and father involvement in day care

Twenty-eight dual-earner couples were interviewed 10 times each to determine their involvement in their young child’s day care center. Mothers picked up the child significantly more often than did fathers. Mothers and fathers spent about equal amounts of time in the center during their visits. In comparison to fathers, mothers were significantly more communicative with caregivers and the director. There were many similarities between mothers and fathers in the topics they discussed with staff.     

Building capacity for parent involvement through school-based preschool services

This study investigated whether experience with school-based preschool services would build parents' capacity for school involvement. The research design compared parent involvement in kindergarten across school sites differing in the availability of preschool services, including sites with (1) multiple, integrated school-based preschool services, including seamless child care, family support programmes, and kindergarten (MS); (2) a single preschool family support programme; and (3) no preschool services. Parent surveys were employed with 206 parents of four-year-old and five-year-old children to investigate whether the site types differed in terms of several dimensions of parents' involvement: (1) feelings of efficacy in helping their children succeed in learning, (2) perceptions of their responsibilities in communicating with the teacher, and (3) perceptions of whether their children's school works with them. Parents in the MS sites reported feeling more efficacious, more welcomed by, and more responsibility to link with the school.     

Increasing Fathers’ Involvement in Child Care With a Couple‐Focused Intervention During the Transition to Parenthood

Abstract: In this article, we report the results of an evaluation study of a program for couples during the transition to parenthood on father involvement in child care. One‐hundred‐twenty couples were assigned to 1 of the 3 groups: a treatment group that received the Welcome Baby new‐parent, home‐visiting program focused on infant development and health, supplemented with the self‐guided Marriage Moments program focused on strengthening couple relationships; a comparison group that received just the Welcome Baby program; or a control group. The study revealed that the treatment group fathers were more involved in child care than control group fathers, and this finding was replicated in a second evaluation study. Family life educators must be open to the possibility that they may miss a primary intervention target, yet hit a secondary one.     

Teacher burnout and environmental quality in child care centers

The purpose of this study was to examine the relationship between burnout in child care teachers and the environmental quality of the child care center. The questions were: (1) Does burnout in child care workers effect the quality of environment in a child care center? and (2) Is staff burnout related to staff turnover? It was concluded that perceived burnout is not related to the quality of a child care center, and that there is no relationship between turnover and burnout. Other factors, such as long working hours, poor facilities, and inadequate training, might be investigated as factors that may relate to the quality of care a child receives.     

Improving nutrition and physical activity in child care: what parents recommend

A large percentage of children in the United States spend part of their day in out-of-home child care. As rates of obesity continue to rise, especially among young children, child care has become a focus for nutrition and physical activity intervention. Parental involvement is an important component of these efforts. During summer 2006, parents of children in child care were surveyed to better understand their perceived quality of meals, snacks, and physical activity at the child-care center, and their recommendations for improvement. Parents of children who attended 94 licensed child-care centers in North Carolina were invited to complete a brief survey of perceived quality of meals, snacks, and physical activity at their centers using close-ended questions. Open-ended questions were used to identify suggestions for improvement. Five hundred eight parents from 91 child-care centers completed the questionnaire. The majority of parents reported quality of meals and snacks at the center as either excellent (30% meals, 27% snacks) or good (42% meals, 46% snacks). The main recommendations for improving meals and snacks were to increase fruits and vegetables and provide a variety of healthful foods. The majority of parents categorized the quality of physical activity at the center as excellent (36%) or good (46%), and suggested more structured, outdoor activities for children. Findings from this study provide insight into key areas of concern for parents regarding the nutrition and activity environment of child-care centers. This information may be used to create or modify interventions or policies and to help motivate parents to become advocates for change in child care.     

Experiences of Finnish care leavers of their involvement in the aftercare services for child welfare clients

Children and young people placed in out-of-home care form a vulnerable group. Their involvement in decision making of their future is undermined by the lack of a safe ‘adult security net’ and the brevity of the period in which they are supposed to gain independence. Although there are some studies showing that the opportunity to affect the decision making is insufficient, there are no studies about how the involvement might actually be developed. This study describes young people's experiences of their involvement and the developmental needs for it in aftercare services for child welfare clients. The design was that of a qualitative explorative study. In total, 16 care leavers participated in the study. Data were collected by thematic interviews in autumn 2016 and analysed by qualitative content analysis. Good value-based collaboration with the staff and the possibility of mental, concrete and social support enhanced the young people's active involvement in their lives. The topics the interviewees wanted to see developed included the core values in the aftercare services, the comprehensiveness of the support and a future-oriented approach. Collaborative relationships should, it emerged, be based on individuality, equality, fairness, trust, a non-judgmental attitude, flexibility and safety and a general approach valuing, respecting, listening to and empowering the young person. Support should be provided with a comprehensive approach and in a multiprofessional and coordinated manner. The transition period to an independent life should be extended and carefully prepared, with an option for the continuity of the collaboration with the employees if needed.     

Child involvement in the paediatric consultation: a qualitative study of children and carers' views

Background This study aimed to investigate child and carers' attitudes towards child involvement in paediatric consultations. Methods Semi‐structured qualitative interviews explored child and carers' attitudes towards child involvement at different stages of the paediatric consultation process. Twenty families (21 children, 17 mothers and 5 fathers) were interviewed following a paediatric (index) consultation in two UK paediatric inpatient and outpatient departments. Results All but one family felt the child should be involved at some stage of the consultation process but the desired extent and nature of involvement depended on child, family and illness characteristics, as well as on the stages of the consultation. During history gathering, some parents and children felt it was the decision and responsibility of the parent to facilitate communication between the child and the doctor. Others expected the doctor to decide when and how to facilitate this process. At diagnosis the desired amount of information given to the child increased with increasing maturity in the child. Some felt making a diagnosis should be a collaborative process; others felt it was solely the domain of the doctor. In discussing and making a treatment plan, some children wanted to be given the choice of being involved and some wanted their parents to be responsible for implementing the plan. Some families with a seriously ill child, however, wanted the burden of involvement in the management plan taken away from them. Conclusions Families vary in their views about involvement of children in paediatric consultations in a way that may be unique to each child, family and illness. Moreover, different views were expressed about involvement in each stage of the consultative process and in management of the child's health. The challenge for doctors is to determine the level of involvement and information exchange favoured by a particular parent and child. Good practice recommendations emerging from the analysis are described.     

Doing involvement: A qualitative study exploring the ‘work’ of involvement enacted by older people and their carers during transition from hospital to home

ContextBeing involved in one''s care is prioritised within UK healthcare policy to improve care quality and safety. However, research suggests that many older people struggle with this.DesignWe present focused ethnographic research exploring older peoples'' involvement in healthcare from hospital to home.ResultsWe propose that being involved in care is a dynamic form of labour, which we call ‘involvement work’ (IW). In hospital, many patients ‘entrust’ IW to others; indeed, when desired, maintaining control, or being actively involved, was challenging. Patient and professionals'' expectations, alongside hospital processes, promoted delegation; staff frequently did IW on patients'' behalf. Many people wanted to resume IW postdischarge, but struggled because they were out of practice.DiscussionPreference and capacity for involvement was dynamic, fluctuating over time, according to context and resource accessibility. The challenges of resuming IW were frequently underestimated by patients and care providers, increasing dependence on others post‐discharge and negatively affecting peoples'' sense and experience of (in)dependence.ConclusionsA balance needs to be struck between respecting peoples'' desire/capacity for non‐involvement in hospital while recognising that ‘delegating’ IW can be detrimental. Increasing involvement will require patient and staff roles to be reframed, though this must be done acknowledging the limits of patient desire, capability,and resources. Hospital work should be (re)organised to maximise involvement where possible and desired.Patient/Public ContributionOur Patient and Public Involvement and Engagement Panel contributed to research design, especially developing interview guides and patient‐facing documentation. Patients were key participants within the study; it is their experiences represented.     

Encouraging Men to Enter the Field of Child Care: What Can Be Done?

Child care has traditionally been viewed by society as “women's work”. However, men who work in child care programs help challenge stereotypes and allow children to view males from a different perspective. The question then becomes one of how to encourage men to enter the field of child care. This article examines a few of the obstacles that prevent men from working in child care centers and provides one man's story about how he came to work in a child care facility. This is followed by suggestions of ways men could be encouraged to enter and stay in the field of early childhood education.     

Fathering and adolescents' psychological adjustment: the role of fathers' involvement, residence and biology status

Background Studies on fathering and child mental health are now increasingly looking for specificity in children's psychological adjustment, indicating whether the impact of fathering is diagnostically specific or non‐specific. Methods Data from 435 fathers of secondary school‐aged children in Britain were used to explore the association between resident biological fathers', non‐resident biological fathers' and stepfathers' involvement and children's total difficulties, prosocial behaviour, emotional symptoms, conduct problems, hyperactivity and peer problems (all measured with the Strengths and Difficulties Questionnaire) in adolescence. Results After controlling for child‐, father‐ and family‐related factors, fathers' involvement was negatively associated with children's total difficulties and hyperactivity, was positively associated with children's prosocial behaviour, and was unrelated with children's emotional symptoms, conduct problems and peer problems. There was no non‐resident biological father effect. Compared with resident biological fathers, stepfathers reported more total difficulties, conduct problems and hyperactivity in their children even after adjusting for involvement. Conclusions Whether this reflects stepfathers' low tolerance levels or biological fathers' complacency, as sociobiologists would argue, or whether this is due to pre‐existing predispositions of children in families which separate and restructure, to the effects of these multiple family changes or to the high exposure of children in restructured families to parental risk factors, is, given the data available and the study design, unclear. However, this study showed that, compared with their peers in biological father families, adolescents in stepfather families are perceived to be at higher risk of behaviour problems, and that father involvement is related to specific aspects of child adjustment.     

Is There a Difference Between Center and Home Care Providers’ Training, Perceptions, and Practices Related to Obesity Prevention?

To compare the obesity related training, practices, and perceptions of home child care providers and center care providers. A self-administered survey was collected from child care providers who attended local child care training workshops in east central Illinois from March 2009 to August 2010. Study results were based on responses from 88 home care providers and 94 center providers. The survey questions addressed child care providers?? training in the prior year, their obesity prevention practices including written policies, their perceptions of influences on children??s health, and factors determining food menu selection. Paired t tests and Chi-square tests were used to compare the difference by child care type. 81.9% of home care providers and 58.6% of center care providers received nutrition training, while 66.7 and 43.0% of these providers received physical activity training, respectively. Nutrition content, guidelines or state regulations, and food availability were the most important factors that influenced both types of care providers?? food service menus. Both care provider types perceived they have less influence on children??s food preferences, eating habits, and weight status compared to the home environment. However, home care providers perceived a smaller discrepancy between the influences of child care and home environments compared to center care providers. Compared to center providers, home care providers were more likely to have had training, be involved with health promotion activities, and rate their influence higher on children??s health behaviors. Findings underscore the need for obesity prevention efforts in both types of child care settings.     

A consultation leaflet to improve an older patient''s involvement in general practice care: a randomized trial

OBJECTIVE: To evaluate the effects of a programme to enhance the involvement of older patients in their consultations in general practice. DESIGN: Cluster randomized trial, in which data was collected from different cohorts. SETTING AND PARTICIPANTS: Twenty-five general practices in the south-east part of the Netherlands and their patients aged 70 years and over. INTERVENTION: Patients in the intervention group received a leaflet to help them prepare for the consultation. General practitioners (GPs) received an outreach visit to optimize older patients' involvement when visiting their GP. Patients in the control group received usual care. MAIN OUTCOME MEASURES: Questionnaires measuring involvement (COMRADE), enablement (Patient Enablement Index) and satisfaction with their care (EUROPEP). RESULTS: Pre-intervention 315 patients and post-intervention 263 patients were included. Subjects were satisfied with their involvement and the GP's behaviour during the consultation. No differences in effect as a result of the leaflet on involvement, enablement or satisfaction were found between the intervention and the control group. Of 318 patients who received the leaflet and visited their GP in the intervention period, 47 patients used the leaflet. These users were more accustomed to prepare themselves for consultations. Users reported more psychological problems than non-users. CONCLUSIONS: No relevant effects of the implementation programme on involvement, enablement or satisfaction were found. Other strategies are needed to enhance involvement of older patients in their care. Alternatively, older patients may perceive themselves sufficiently involved.     

Father Involvement and Early Intervention: Effects of Empowerment and Father Role Identity

The family‐centered service delivery model used in early intervention is meant to empower families of children with disabilities. The present analysis examined the effects of empowerment and father identity on father involvement with children with disabilities. Father involvement was measured using three indices: attachment (i.e., feeling a strong connection to the child), engagement (i.e., participating in activities with the child), and responsibility (i.e., meeting the child's needs). Father empowerment and father identity, measured as salience, satisfaction, and reflected appraisals, consistently predicted higher levels of father involvement in hierarchical regression models. In addition, mediation analyses revealed that father identity partially mediated the relationship between empowerment and father involvement. These findings support the family‐centered service delivery model and suggest that it may be able to improve the lives of children with disabilities by enhancing father role identity and subsequent fathering activities.     

Parent involvement in child care settings: conceptual and measurement issues

This paper discusses the conceptualization and measurement of Parent Child Care Involvement (PCCI) and questions whether PCCI should be included in high-stakes quality ratings. It presents data on several PCCI measures, including one used by the National Association for the Education of Young Children, the Parent Caregiver Relationship Scale (Elicker et al., 1997) and PCCI items from the National Longitudinal Survey of Youth and the Early Childhood Environment Rating Scale—Revised (ECERS-R). Across these measures parents uniformly describe child care providers as welcoming and supportive even when other quality measures reveal significant problems. Providers display similar positivity when reporting their own PCCI efforts. A new author-devised measure, Family-Provider Partnership, produces similar positivity bias. Nevertheless, Family-Provider Partnership scores were strongly associated with other measures of child care quality, including the ECERS-R Infant-Toddler Environment Rating Scale (ITERS), ratios and staff credentials. Such relationships justify inclusion of PCCI in child care quality ratings.